White Coat Wisdom

Antidepressants: 5 Facts You Need to Know

January 26, 2020 by 0 Comments

Prescriptions being written for antidepressant and antianxiety medications are on the rise, especially in the United States. Approximately 1 in 8 Americans take a medication for their mood and the majority of these people are women.  Are you surprised by this statistic? I’m not.  

I see this in my practice every single day. Women and men alike come to the office complaining of excessive fatigue, lack of interest, difficulty concentrating and irritability.

I’m a huge advocate for antidepressant therapy and I’m not ashamed to admit that I took an antidepressant more days than not over the past ten years. What does surprise me though is how little patients know about these medications, even if they have been on them before.  

Here are 5 facts you need to know about antidepressant/antianxiety medications.

  1. They Take Time To Work:   Antidepressants are not antibiotics. Unlike antibiotics which begin taking effect after the first dose, antidepressant therapy will not provide improvement in symptoms in the first 24-48 hours.  In fact, most of these medications take 4-6 weeks before you will begin to notice a difference.
     
  2. You Shouldn’t Feel Like a New Person: Let me be clear, you should feel better  on the medication but as a general rule I tell my patients “I want you to feel like yourself again. I want you to feel like a better version of yourself than you feel right now.”  If your antidepressant makes you feel physically ill, completely numb and void of all emotions, then it is not the right medication for you.  This does not mean that antidepressants are not right for you, it means that particular medication is not for you. 

  3. Antidepressants Don’t Fix Everything: Life still happens. No amount of medications will make you love your job, fix your relationship or make grief or disappointment disappear. Antidepressant medication will help balance the neurotransmitter chemicals in your brain so that you are no longer clinically depressed or anxious. Happiness however does not come in a pill.  Remember that sadness is the opposite of happiness and sadness is not the same thing as clinical depression.  A large portion of being content with your life is up to you and for that reason I strongly encourage therapy in some form or another.  Ideally I would recommend counseling with a licensed counselor, but if you are hesitant other options include attending church, educating yourself (from reliable resources) about anxiety/depression, confiding in a trusted friend, yoga, meditation and journaling. 

  4. Choosing One is an Educated Guess: As medical providers we do our best to tailor medications specifically to a patient, but every patient is unique in chemical makeup and genetics.  Prozac may have worked wonders for your coworker, but it may cause horrific side effects for you.  Wellbutrin may have helped your aunt’s depression, but it may worsen your anxiety. When starting an antidepressant, make sure you are completely honest with your medical provider regarding your symptoms and any concerns you may have. Up until recently, providers would prescribe a mediation, have the patient return in 4-6 weeks and report on their results in order to determine if the medication was successful.  Today we have advanced medical technology that can narrow down appropriate choices for antidepressant therapy based on the patient’s unique DNA makeup.  Tests like GeneSite provide comprehensive information on the medications that will work best for each patient.  The test requires a swab of saliva from the inside of your cheek and within two weeks a report is generated.  
                Antidepressants and antianxiety medications are grouped into one of three categories, conveniently color coded as red (stop), yellow (proceed with caution) and green (go). Using these results, your medical provider can narrow down your choices for a medication that will be best tolerated and most efficacious for you.  Keep in mind, this test does not diagnose depression or anxiety, but will provide insight as to which medication will work best. If you have been on a medication in the past and either had side effects or found it unhelpful, ask your provider about this test. The answers may surprise you.

  5. Timing is Everything: Deciding to start an antidepressant for your mood is a big decision, but deciding if and when to stop a medication is equally important.  The best time to stop a medication is when you expect to have a constant exposure to sunshine, warm weather and fresh air.  Let’s face it, most of us feel better in the spring and summer months, especially if you live in the north or Midwest when half our year is spent indoors due to snow and cold temperatures!  When you consider stopping one of these medications, discuss this with your medical provider first.  Many of these medications require a gradual decrease in dosage and you will feel much better if you do this during late April or early May compared to stopping the medication in January. 

Remember, there is absolutely no shame in starting one of the medications; they can do wonders for your mood (I’m living proof). 

Talk with your medical provider and let me know if you have any questions about starting a medication for anxiety and/or depression.

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New Year, New You: How to Really Make a Change

January 6, 2020 by

Are you sick of them yet? You know the posts, the ones that flood social media the first week of the year claiming “this is my year!” 

This year I will eat all the kale and give up carbs.
This year I will go to the gym every day after work.
This year I will start a business and quit my dead end job.
This year I will write a novel. 
This year I will _(fill in the blank)____. 

Don’t misunderstand, I have been there.  I was notorious for making the New Year’s resolutions only to be half-assing it by January 27thand having completely abandoned my resolution by the second week in February at best.  One year I tried to increase my chances of being successful with maintaining my resolution by making a goal that wasn’t as big.  Instead of “I will write every single day” I would tell myself “I will post on my blog twice a month.”

Big surprise, making my goal smaller didn’t work either. 

I also tried to set myself up for success by making sure that I had all of the tools at my disposal so when that designated start date arrived, I would be ready.  If my goal was to “get healthy” (a rather vague goal if you ask me) I bought cute work out clothes with motivational quotes on the front, bought Tupperware free of leftover spaghetti stains for meal prep and downloaded all of the high energy 90’s pop music on my ipod.  I scoured Pinterest for all the quinoa recipes and made my grocery lists in the order that I would find them in the produce section. 

I prepared everything I could…. except my mindset. 

As it turns out, this was my missing golden ticket. 

In early 2019 I began to feel extremely uncomfortable and anxious. What was worse was I couldn’t pinpoint the root cause.  My life is relatively boring and predictable. I don’t say this flippantly, but as far as trauma and stress go, I’m as vanilla as it gets.  Having gotten married at 23 and my first child at 25, I spent a large portion of my twenties raising babies and establishing my career.  Now here I was, ten years and four children later and I felt like a stranger in my own skin.  I ultimately found myself blindly starting a path to self-discovery, although I was completely oblivious to it at the time. 

I read everything I could get my hands on that spoke to that small spark inside me; that fire that has been suppressed by sippy cup refills and preschool drop offs.  I listened to podcasts on loop and took every recommended test and self-help tool to learn more about myself. 

Basically, I spent 2019 figuring myself out.  

Despite my solo work, I continued to feel uneasy. A leap of faith in July landed me in Dallas, Texas with one of my girlfriends for a conference that I didn’t realize I needed until my feet hit the “You Were Made for More” stamped pavement. The conference solidified everything I had been struggling to piece together for the past few months: it wasn’t my lack of motivation, knowledge or preparation that kept me from achieving my goals.

It was my mentality.

By putting in the work, (re)discovering who I am, I have been able to shift my perspectives and focus my efforts on using what I have learned and apply it to maximize results in all areas of my life.   My energy level, mental clarity, marriage, health, friendships, work productivity, sleep, motivation and confidence all improved in 2019.  Are they perfect?  Hell no, but I’m much further along than I was before. 

You don’t need to wait until Monday to start a healthy eating plan.

You don’t need to have a fancy website to start a business.

You don’t need an anniversary to celebrate your marriage.

And you certainly don’t need a new year to become a better/stronger/smarter/richer/healthier/happier person.

A start date is just that, a day on the calendar. If you want change, real change, change your current way of thinking. If your current mindset was serving you, what you are doing would be working.

If your mentality hasn’t changed since last year; if you haven’t learned how to combat those toxic voices that tell you to quit, how to ward off those triggers that make you sink back into your old habits, or how to push through your comfort zone when motivation is lacking then no amount of “this is my year” Facebook posts or vision boards will generate new results.

So set the big goals for yourself, but remember that drafting a game plan is only the beginning of the play. Execution of the plan and following through with your commitment when it becomes inconvenient is the hardest part.

“Set big goals for yourself, but remember
that drafting a game plan
is only the beginning of the play.”

Prepare for errors, I assure you they will happen and evaluate the weaknesses in your internal blueprint that may throw you off course. No one else can hold you back, but you can.

Figure out who you are; what drives you, what limits you, what do you do to sabotage your goals and plan accordingly.

This can be your year, but you have to change in order to see results.

Birth Stories - Family - Motherhood - Pregnancy

Always Kiss Your Momma

October 8, 2019 by 1 Comment
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The day Alexander was born I became a “boy mom.” (Although to be honest, I was always annoyed by the phrases “boy mom” and “girl mom” as if that made any difference to parenting. Moms with girls could have rough and tumble little girls who preferred mud pies over Easy Bake ovens; Moms with boys could have soft spoken little boys who carried a baby doll instead of Spiderman). Nonetheless, when Xander was born we unofficially met our gender quota and could relax in knowing that we would no longer be asked the intrusive question “are you going to try for a boy?”

After the delivery of each child I would stare at my sweet newborn’s face and marvel how something could fit so perfectly into my heart despite only arriving a mere hour ago. I would gently rock the new love of my life, pray obsessively over their little body and make promises that I hoped I would never break.

“Dear God thank you for this miracle that you have given us. Please help guide me to be the mother that this child deserves.”

As I kissed his sweet face I whispered, “I promise to nurture you in every way that I can. I promise to guide you as your grow into the incredible person I know you will become. I can’t promise that you will always be happy and I guarantee you will have your heart broken throughout your life, but I can promise that I will always be there for you. I promise to love you for who you are, not who I want you to be. I promise to let you make your own mistakes and choices, even when it is not what I would choose for you. I will teach you strength, compassion, truth and empathy. I promise to teach you manners, how to be respectful, how to treat girls-especially your sisters and momma….”

I remember pausing at that moment, alone with him in the middle of the night, and realizing that I would forever be the first woman he loved. For some reason it seemed more pivotal than it did with my girls. I knew that for the first few years of his life the sun would rise and set with me and as a pre-schooler he would announce “when I grow up I’m going to marry Momma.” I also knew that as the years passed this would fade and he would eventually grow to become someones boyfriend, fiancé and (God-willing) husband.

Post-delivery hospital memories are usually a blurry dream-like state for me, but this is a memory I have managed to keep clear in my mind. As tears welled in my tired eyes I made one more promise to Alexander,

“I promise to remind you to always kiss your momma.”

I realized that for the first eighteen-ish years of his life, he would need me to reassure him of my unending love for him. But as he grew and I began to feel the stinging pull of my baby boy leaving? I may be the one who needed the reassurance.

To this day, if you ask Alexander ‘what is the number one rule in this house?” He will respond with a toothless giggle, “always kiss your momma.”

It’s a ‘rule’ we practice nightly as I tuck him into bed. Still young enough to need a nightlight and his ‘Buddy’ blanket, but old enough to no longer need his mom’s lullabies and rocking chair cuddles, he will declare “always kiss your momma” before each goodnight kiss. Some nights I’ll tease him and ask “what about when you are in 3rd grade, 4th grade or 5th grade?” He will smile and say “Ill still always kiss my momma.”

“What about when you have a girlfriend?”
“Eww! I’ll still kiss my momma!”

As he leaves for school, his backpack bounces when he runs back to me on the front porch. The bus comes to a stop in front of our house and he gladly make his school mates wait as he says “I didn’t forget mom. Always kiss your momma.”

When I leave for work in the morning, I am frazzled and balancing my planner and coffee in one hand, quickly shelling out hugs, kisses and ‘you’re going to do great on your test today’ affirmations. Alexander reminds me “hey! Always kiss your momma!”

I’m not naive and I know it may not always be this easy. Someday his friends will be hangin’ around and he will be embarrassed. As a teenager he will inevitably ‘hate’ me for one reason or another and may refuse to show any form of affection as a means of retaliation (and I will have to try my damnedest to not let him know how much it hurts me). He may have an adoring girlfriend and reserve all of his affections for her. It will be during those years that I will fondly remember the memories we are creating today; the way he holds my face in his little hands, the way he giggles and the way he proudly and openly declares his love for his momma.

Someday the lap sitting, cuddles and calling me “momma” will fade into high fives and ‘hey mom”. He will likely stand taller than me, his voice will grow deep and his face will be rough with stubble while I look back and fondly remember the memories of today.

A mother’s love never dies, nor does the love a child has for his mother and I think it is important that we teach children to not be ashamed to show this love. I think as parents it should be our mission to show children, especially young boys, that affection is not a sign of weakness nor is love something that you should be ashamed of or kept hidden.

Even though this tradition began the day Xander was born, nowadays all four of my children happily follow this family “rule.” Every night I thank God for gifting me these children and my love for them does not change based on their gender. I am both a “girl mom” and a “boy mom” and I wear these badges with honor. I continue to ask for God’s guidance as I strive everyday to be the mother that they deserve. I am sure that some days I fall incredibly short of being a perfect mother, but I pray that my children never doubt my love for them and that they never stop kissing their momma.